取手足太阳之经。
经云∶足太阳之脉,是动则病项似拔,视虚盛陷下取之。又云∶项痛不可俯仰,刺足太阳。
不可以顾,刺手太阳。又云∶风颈项痛,刺风府。又云∶邪客手足太阳之络,令人头项肩痛,
刺足小指爪甲上与肉交者二 立已。
春甫云∶身体痛者,种种不同,风、寒、湿、痰者多。风寒痛,明知得于寒邪,而脉浮紧,
湿痰留滞关节,一身尽痛。有风湿相搏,肢体重痛;有阴毒伤寒,身如被杖之痛者;有湿郁
而周对作痛;有伤食滞而身作痛;痰滞经络而作块痛;致于骨节酸疼,或寒或热,皆宜随证审其
病机,素昔所感寒热虚实而施治之,无不中也。
凡饮酒之人时作身痛,皆湿郁,或为项肿臂痛,或发热而呕吐痰涎,盖热在上焦,不能
清利,日久酝酿生痰,留饮湿邪,郁于项臂之间,不肿则痛,其为痰为饮为涎,三者亦各有别,
治有所不同也。湿邪随气上浮于肺,壅嗽发动,痰也;聚于脾经,随气溢口角,流出不禁者,
涎也;惟饮生于胃腑,为呕为吐,胃家之病,饮之证也。
六脉俱紧,为伤寒太阳经表证。脉沉而紧,身痛,为阴毒伤寒。伤寒汗后身痛,脉弦而迟。
脉缓者,乃湿
流关节。
周身骨节疼痛,多作湿治。苦是头疼发热而身亦痛,此为伤寒,苦非盛寒时必是伤风证,
如此只须发散而身痛自愈。明知饱食或着冷着气,发热身痛者,宜消导之。病后及汗下后而
身痛者,此为气血不足也,宜六君子汤加当归、川芎之类,其痛自除。
选取手足太阳经的穴位进行治疗。
医经记载:足太阳膀胱经发生病变时,会出现颈部僵硬如同被拔扯的症状,治疗时应根据脉象的虚实盛衰及穴位陷下的情况来选取穴位。又说:如果颈部疼痛导致不能前后俯仰,应针刺足太阳经的穴位。如果颈部疼痛导致不能左右回顾,应针刺手太阳经的穴位。又说:因风邪导致的颈项疼痛,应针刺风府穴。又说:邪气客居于手足太阳经的络脉,会导致头部、颈部和肩部疼痛,针刺足小趾爪甲角与肉交接处旁的两个穴位(至阴穴),疼痛可立即停止。
徐春甫说:身体疼痛的情况多种多样,大多由风、寒、湿、痰引起。如果是风寒引起的疼痛,虽然明确知道是感受了寒邪,但脉象浮紧;如果是湿痰停滞在关节,会导致全身都疼痛。有风湿相互搏结,导致肢体沉重且疼痛的;有阴毒伤寒,身体疼痛如同遭受杖击般的;有湿气郁滞导致周身交替作痛的;有饮食损伤、食积停滞导致身体疼痛的;有痰浊阻滞经络导致局部形成肿块并疼痛的。至于骨节酸痛,或伴有寒象或热象,都应当根据证候仔细审察其病机,依据患者素日所感受的寒热虚实性质来进行治疗,没有不准确的。
凡是饮酒的人时常出现身体疼痛,都是由于湿气郁滞所致。有的表现为颈部肿胀、手臂疼痛;有的发热并呕吐痰涎。这是因为热邪在上焦,不能清利,日久酝酿生痰,留滞饮湿邪气,郁结在颈臂之间,如果不肿胀就会疼痛。其中痰、饮、涎三者虽有区别,但治疗方法也各不相同。湿邪随着气机上浮于肺,导致咳嗽发作,这是痰;聚集在脾经,随着气溢出到口角,流出而止不住的,这是涎;只有饮产生于胃腑,表现为呕逆或呕吐,这是胃部的疾病,属于饮证的范畴。
六脉都呈现紧象,是伤寒太阳经表证的表现。脉象沉而紧,身体疼痛,是阴毒伤寒的表现。伤寒发汗后身体仍然疼痛,脉象弦而迟。脉象缓的,是湿气流注于关节的表现。
周身骨节疼痛,多按湿气治疗。如果是头痛发热且身体也疼痛,这是伤寒;如果不是在严寒时节,必定是伤风证,这种情况下只需使用发散法,身体疼痛自然痊愈。如果明知是饱食过度,或者受冷、情绪不畅导致发热身痛,应当使用消导法。病后以及经过发汗、攻下治疗后出现的身体疼痛,这是由于气血不足所致,适宜使用六君子汤加入当归、川芎等药物,疼痛自然消除。
Select acupoints from the Foot-Taiyang and Hand-Taiyang meridians for treatment.
The medical classics state: When the Foot-Taiyang (Bladder) meridian is affected, it causes disease characterized by a stiff neck as if being pulled. Treatment should involve selecting acupoints based on the excess or deficiency of the pulse and the depression of the points. It further states: If there is neck pain preventing flexion and extension, needle the Foot-Taiyang meridian. If there is neck pain preventing turning the head, needle the Hand-Taiyang meridian. It also states: For wind-induced neck and nape pain, needle Fengfu (DU16). Furthermore: When pathogenic factors invade the collaterals of the Hand and Foot Taiyang meridians, causing pain in the head, neck, and shoulder, needle the two points located at the junction of the nail and flesh on the little toe (Zhiyin, BL67); the condition will resolve immediately.
Xu Chunfu stated: Body pain presents in various forms, most commonly caused by Wind, Cold, Dampness, and Phlegm. In cases of Wind-Cold pain, although it is known to result from Cold pathogen, the pulse is floating and tight. In cases where Damp-Phlegm stagnates in the joints, the entire body may ache. There are cases of Wind-Dampness combusting with each other, leading to heavy and painful limbs; Yin-Toxin Cold Damage, where body pain feels like being beaten with a staff; Dampness stagnation causing alternating pain throughout the body; Food Injury with stagnation causing body pain; Phlegm stagnation in the meridians causing localized masses and pain. Regarding soreness and pain in the bone joints, whether accompanied by Cold or Heat symptoms, one must carefully examine the pathogenesis according to the syndrome, and treat based on the patient's historical exposure to Cold, Heat, Excess, or Deficiency, ensuring accuracy in every case.
Individuals who consume alcohol often experience episodic body pain due to Dampness stagnation. Some present with neck swelling and arm pain; others have fever accompanied by vomiting of phlegm-saliva. This occurs because Heat in the Upper Jiao fails to clear and drain properly, eventually fermenting into Phlegm over time. The retained Drink and Dampness pathogens stagnate between the neck and arms; if not swollen, they cause pain. Although Phlegm (Tan), Drink (Yin), and Saliva (Xian) are distinct entities, their treatments differ accordingly. When Dampness rises with Qi to obstruct the Lungs, triggering cough, this is Phlegm; when it gathers in the Spleen meridian and overflows from the corners of the mouth uncontrollably, this is Saliva; whereas Drink originates in the Stomach, manifesting as retching or vomiting, representing a Stomach disorder classified as a Drink syndrome.
A tight pulse in all six positions indicates a Taiyang Exterior Syndrome of Cold Damage. A deep and tight pulse accompanied by body pain indicates Yin-Toxin Cold Damage. Body pain persisting after sweating in Cold Damage, with a wiry and slow pulse, requires specific attention. A slow pulse indicates Dampness flowing into the joints.
Pain in the bone joints throughout the body is generally treated as Dampness. If accompanied by headache, fever, and body pain, it is Cold Damage; if not occurring during severe cold weather, it is likely a Wind Injury syndrome. In such cases, only dispersing methods are needed, and the body pain will resolve spontaneously. If body pain and fever are clearly caused by overeating, exposure to cold, or emotional constraint, resolving and guiding-out methods should be used. Body pain occurring after illness or following sweating and purging therapies indicates insufficiency of Qi and Blood; Liujunzi Tang (Six Gentlemen Decoction) supplemented with Danggui (Angelicae Sinensis Radix) and Chuanxiong (Chuanxiong Rhizoma) is appropriate, and the pain will naturally cease.